What does this MRI report indicate?

default
Posted on Tue, 28 Jun 2016 in Brain and Spine
Question: is flattening of the ventral thecal sac serious

I also have central disc protrusion with posterior spurring. With moderate left and mild right neural foraminal narrowing disc C4-C5
doctor
Answered by Dr. Dariush Saghafi 27 minutes later
Brief Answer:
Typically considered insignificant finding

Detailed Answer:
"Flattening of the thecal sac" in the broadest sense of the statement generally refers to a compression of a sac technically called "the meninges." If there is "flattening" seen on an MRI image the implication is that SOMETHING is pressing on this sac from the other side. That SOMETHING can be a lot of things but mostly likely turns out to be either a herniated/bulging disk or from calcifications or bony spurs of the spinal column which can then NARROW the space through which the sac passes. Inside the sac, of course, is the spinal cord and the nerve roots which ultimately are what the radiologist looks at to tell if there is any reason to suspect compression at the level of these roots which could then, more easily explain the presence of pain.

It is commonly seen in patients just due to the aging process and onset of arthritic changes which we all begin experiencing after about age 40-45 whether we have pain in the neck or back or not. Flattening of the thecal sac is often seen in AYMPTOMATIC patients (patients who are otherwise normal and not complaining of anything).

Usually, when there is THECAL SAC compression or flattening without involvement of the nerve roots at that level then, the finding is merely noted for the sake of completeness and nothing more can be said relative to any symptoms of pain, numbness, tingling, etc. Compression or flattening can be mild, moderate, or more severe in which case the reader usually starts calling out things like NERVE ROOT COMPRESSION or herniation causing thecal sac deformities, etc. etc.

Therefore, in your case and to once again come back to your question as you've asked it...the simple phrase "flattening of the ventral thecal sac" in and of itself is considered insignificant in most cases or at worst, of "unknown clinical significance" which means that more information is needed to make the call clinically as to whether or not that is the explanation of any pain or discomfort you may be having in your neck.

The other statement you just added in the last few minutes of a central disc protrusion with posterior spurring simply underscores my point regarding ARTHRITIC CHANGES which are commonplace and do not necessarily help us always identify the origin or cause to pain and other symptoms but they simply let us know that "arthritis" is present in that joint or at that level. Central disc protrusions by the way, are almost never believed to be bad players when it comes to sac or nerve root compressions since nerve roots come out from the LATERAL RECESS areas. A CENTRAL PROTRUSION (right down the center or in the middle) would anatomically MISS the nerve roots and therefore, not be considered as much of a risk to pain or discomfort that were felt either in the neck or radiating down one arm or another.

Hope that helps.

If I've satisfactorily addressed your questions could you do me the kindest of favors by CLOSING THIS QUERY and be sure to include some fine words of feedback on your opinion as to our transaction?

Many thanks for posing your question to our attention on this network and do not forget to recontact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 18 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2474 Questions

premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,  
Medical Topics ,   ,  

Recent questions on  Meninges

doctor1 MD

Hi Doctor. I m a 28 yr old Indian Male. I recently had a small fall while rock-climbing and passed out and do not remember clearly the events of...

doctor1 MD

my name is mr. mukul kanti halder age 45 resident west bengal i am suffering arachnoid cyst in left temporal are with vertigo,nauses and vomiting...

doctor1 MD

i got blood leakage before ejacuvation(with semen in same flow).but i wont masturebate even frequently.i make it 3or4 days once only that too...

doctor1 MD

I had a dura tear right under my brain it was so bad it actually lowered my brain I was put on bed rest for 2weeks I feel much better but I stil...

doctor1 MD

What is the best oral antibiotic for lyme disease that has effected the nervous system?

doctor1 MD

feeling hot and cold elevated heart rate right side of neck hurts to the touch feel very lethargic and achcey all over

doctor1 MD

Baby observed with the tumor on lower back which growing day by day. Doctor asked for the MRI for that MRI of LUMBOSARCAL Spine . Details from the...

Get personalised answers from verified doctor in minutes across 80+ specialties

124 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
backtotop2